Sohail Hafeez.
Orthopedic surgery in civil war - line year experience at Pak UNOSOM Hospital Somalia.
Pak Armed Forces Med J Jan ;53(1):84-8.

The conduct of civil war and utilization of medical resources is different from those of conventional wars. This paper addresses the nature of orthopaedic and trauma cases treated at a level three base hospital in a period of one year during the civil war in Somalia. This is an observational study/ surgical audit of 217 orthopaedic cases treated at Pak UNOSOM hospital, Mogadishu. Three different categories of cases were treated in the hospital, the majority being war related missile injuries to the extremities which required debridement and external fixation. In addition to fresh war trauma, the case mix also included old war injuries like post-traumatic osteomyelitis, mal-unions and infected non. unions. The second group included non-combat casualties and required definitive internal fixation as in any civil setup. The third group included routine orthopaedic cases like degenerative, infective and neoplastic diseases of musculoskeletal system. The trauma surgeon should be well trained in the use of external fixator, internal fixation and other routine orthopedic diseases. He should be prepared to handle neglected trauma and his armament must include an adequate supply of implants and external fixator. In addition, he should be prepared to perform laparotomy, thoracotomy, craniotomy and vascular repair. The administrative, logistic, security and medical evacuation also require special training.

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